State-by-state look at how many parents aren’t vaccinating their children

While national vaccination rates among children entering kindergarten at public schools are high overall, with nearly 98.2 percent being fully immunized, an increasing number of parents are opting to exempt their kids from shots in some parts of the country.

In California, exemption rates are increasing, especially in certain geographical pockets such as Marin County where rates doubled from 4.2 percent to 7.83 percent between 2005 and 2013. In the past decade in Oregon, exemption rates have also doubled, leading the state to have the highest exemption rates of any state.

Diseases are breaking out in these hotbeds of vaccine refusal. During a countrywide pertussis outbreak in 2010, California saw a third of the country’s cases. Ten people died during the outbreak in the Golden State.

The Mother Jones news organization put together a telling series of U.S. maps with a state-by-state look at exemption rates that provide insight into the number of children around the United States who aren’t getting routine vaccinations. The map (above) shows the variance among states.

The federal government doesn’t have a vaccination law but in all 50 states children are required to get certain vaccinations before entering public schools. Depending on the state, children must be vaccinated against some or all of the following: mumps, measles, rubella, diphtheria, pertussis, tetanus, and polio. These diseases are easily preventable but could become deadly in serious cases.

All 50 states allow medical exemptions—a child might have a serious allergy to a vaccine component or may have had a prior adverse event related to an immunization. Most states (except West Virginia and Mississippi) allow religious exemptions. Some states require a family to belong to a religious group with bona fide objections to vaccination, while in other states parents simply sign a piece of paper.

Twenty states allow exemptions for children whose parents have personal belief objections to vaccines. For example, some parents worry that vaccines cause autism so they opt out, even though research shows no connection. The rules around personal-belief exemptions vary, with some states only requiring a parent signature while others want a doctor’s note. Mother Jones also created a map (below) showing how hard it is to file a personal belief exemption in each of the 50 states.

As you might expect, when comparing the two maps, you see that opt-out rates tend to be higher in those states with exemption laws. Mother Jones reports: “…opt-out rates in states that allow personal-belief exemptions are 2.5 times as high as rates in states that only permit religious exemptions.” The end result is that disease outbreaks are more common in states where it’s easier to get an exemption. “Whooping cough rates in states with personal-belief exemptions are more than double those in states that allow only religious exemptions,” according to Mother Jones.

Should states toughen up their exemption laws? The data shows tighter restrictions will increase vaccination rates.

According to Mother Jones:

There’s evidence that tightening exemption laws makes a difference. After reaching an exemption rate of 7.6 percent in 2009, Washington state passed a law requiring parents to get a doctor’s signature if they wanted to opt out of their children’s vaccinations. In just two years, the exemption rate plummeted by more than 40 percent. Pertussis vaccination rates climbed to 92.4 percent in the past school year, representing “the highest pertussis vaccine completion rate for kindergartners since the state began to collect this data in the 2006-2007 school year,” according to the Washington Department of Health.